Getting the Blues Over Diabetes Depiction

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Kate pressed the Accu-Chek needle into her forefinger. The digital meter read up to 282. Her norm was around 90. Jesus, she was off the charts.

She dug into her purse and came out with her kit…She took out a syringe and the bottle of Humulin…She lifted the syringe and pressed it into the insulin, forcing out the air: 18 units…

—The Blue Zone

Eighteen units to bring her blood glucose down to…what? Minus something-or-other?

“It would take me two units,” my friend Liz said. “Maybe two and a half.”

Even zaftig, Type 2, insulin-resistant me would only need 12 units to end up at 90 mg/dl, and Kate was a slim, trim, athletic Type 1. Should author Andrew Gross have named his protagonist Sunny Von Bulow instead?

I’ll get to Humulin in a paragraph or so, but first: 282 mg/dl is “off the charts”? I can show you “off the charts,” and it ain’t no sissy 282!

Now, Humulin is either Regular or NPH insulin (and it’s so 1990s!). The book notes that Kate does two injections a day, but it only mentions Humulin and not what kind, although the fact that she uses Humulin to correct a high would indicate that it is Regular. Regular doesn’t last all that long. Her blood glucose may be somewhat normal part of the time, but what is she the rest of the day? Off the charts?

Today’s regimen, for those of you who don’t know, is a long-acting insulin for a baseline and a rapid-acting insulin to handle any food that you eat and for correcting high blood glucose. Even before rapid-acting insulins were released in 1996, people generally took a combination of NPH and Regular.

The poor woman must not have had very good diabetes self-management education. She leaves for work without giving herself insulin. She skips dinner. She goes all day with just a few bites of salad.

Kate is tough, too. She goes several days (she doesn’t know how many, and neither do I) without taking her insulin and is neither in the hospital nor dead. What a woman!

“Kate’s diabetes was intended to show a character strength,” Gross responded after I e-mailed him about the errors and added, “I have received one or two [comments] from diabetes sufferers before, both critical and positive about Kate’s achievements despite the disease.”

I believe Kate could display character strength and been an achiever while properly managing her diabetes—in which case she could also have acted as an inspiration to people with diabetes and readers could have learned more about diabetes from her.

Geez, no wonder people harbor misconceptions about diabetes—they’re getting misinformation from the media. And that’s all media, from newspapers, to television, to magazines, novels, and movies. In addition, they believe everything they read (or hear) from people who are just as perfect as you and me (which is to say, imperfect). Maybe it’s a case where people don’t know that they don’t know something and innocently repeat myths or outdated information.

(As an aside, it reminds me of the time I worked for an advertising agency and we did a commercial for a drug rehab center. “How did you get that woman to talk about her drug addition?” one person asked my colleague and me one day.

“It’s television,” my colleague responded. “It’s not real.”)

Even worse, however, was a recent column by Peter Gott, M.D., who writes for the Newspaper Enterprise Association. In response to a reader who complained that his doctor refused to issue a prescription for a blood glucose meter, Gott sided with the doctor, basically saying that not everybody needed to check their blood glucose, especially if they’re managing with diet and exercise.

I disagree. Knowing your blood glucose levels can help you determine how different foods and exercise affect your numbers. And, because Type 2 diabetes tends to be progressive, with intensified treatment needed over time, it’s a way to determine when changes in treatment need to take place.

Besides, why discourage somebody who wants to be proactive in managing his diabetes? Just imagine a doctor—read by who knows how many people, by the way—telling somebody he shouldn’t optimize his care.

But I digress.

I’m a firm believer in including diabetes in all manner of media. A novel? Why not? Millions of people have diabetes. Why can’t a character in a work of fiction have diabetes just as a matter of course? After all, we’re in all walks of life in the real world.

But the diabetes information needs to be correct. Think of how many people authors could educate while they entertain.

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